Polyzos Nikolaos K, Sarris Kyriakos G, Pita Afroditi I, Mikrogeorgis Georgios V, Lyroudia Kleoniki M
Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Department of Oral Health and Diagnostic Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT, United States.
Eur Endod J. 2018 Jul 19;3(2):93-100. doi: 10.14744/eej.2018.18291. eCollection 2018.
To evaluate the outcome of initial endodontic treatments performed by undergraduate students in a Greek dental school and to determine the factors that may impact the treatment outcome.
From a randomly selected sample of 677 non-surgical endodontic treatments performed between 2012 and 2015, follow-up appointments were scheduled with patients whose dental records matched the inclusion criteria. After clinical and radiographic examination, the treatment outcome was classified as 'success' (healed/healing) or 'failure' (uncertain/unsatisfactory healing). The statistical analysis of the data was performed using generalized estimating equations. Intra-examiner and inter-examiner agreements were checked with the intraclass correlation coefficient and with Cohen's kappa. The statistical significance level was set at P<0.05.
A total of 244 teeth (349 roots) were included for further analysis, and the mean follow-up period was 2.8 years. Overall, the success rate for the treated roots was 72.8%. Μultivariate analysis revealed four decisive factors as having a positive impact on the outcome, namely, the absence of voids within the root fillings (P<0.001), the absence of pre-operative periapical lesions (P=0.001), the extension of the root filling material by 0-2 mm from the radiographic apex (P<0.001) and the root type (anterior roots: P=0.015 and premolar roots: P=0.011). The association of gender, arch, pulp status and type of coronal restoration with the outcome was not statistically significant (P>0.05). Moreover, when the outcome according to pre-operative periapical status and the technical variables of root fillings (apical extension and density) was investigated, roots without periapical lesion, with a root filling material extended 0-2 mm within the apex and without voids revealed the highest success rate (94.5%).
The success rate of non-surgical endodontic treatments performed in a Greek dental school was in the range of those reported in other studies. The pre-operative periapical status, technical variables of root fillings (apical extension and density) and root type were regarded as significant prognostic factors of the outcome.
评估希腊一所牙科学校本科学生进行的初始牙髓治疗结果，并确定可能影响治疗结果的因素。
从2012年至2015年间随机抽取的677例非手术牙髓治疗样本中，为牙科记录符合纳入标准的患者安排随访预约。经过临床和影像学检查后，治疗结果分为“成功”（愈合/正在愈合）或“失败”（愈合情况不确定/不令人满意）。使用广义估计方程对数据进行统计分析。通过组内相关系数和科恩kappa系数检查检查者内和检查者间的一致性。统计学显著性水平设定为P<0.05。
共纳入244颗牙齿（349个牙根）进行进一步分析，平均随访期为2.8年。总体而言，治疗牙根的成功率为72.8%。多变量分析显示有四个决定性因素对结果有积极影响，即根充物内无空隙（P<0.001）、术前无根尖周病变（P=0.001）、根充材料从影像学根尖延伸0 - 2毫米（P<0.001）以及牙根类型（前牙根：P=0.015；前磨牙根：P=0.011）。性别、牙弓、牙髓状态和冠修复类型与结果的关联无统计学意义（P>0.05）。此外，当根据术前根尖周状态和根充的技术变量（根尖延伸和密度）研究结果时，无根尖周病变、根充材料在根尖内延伸0 - 2毫米且无空隙的牙根成功率最高（94.5%）。
希腊一所牙科学校进行的非手术牙髓治疗成功率在其他研究报告的范围内。术前根尖周状态、根充的技术变量（根尖延伸和密度）以及牙根类型被视为结果的重要预后因素。
